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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Artemether-lumefantrine and dihydroartemisinin-piperaquine retain high efficacy for treatment of uncomplicated plasmodium falciparum malaria in Myanmar
American Journal of Tropical Medicine and Hygiene, Volume 102, No. 3, Year 2020
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Description
The emergence of artemisinin-resistant Plasmodium falciparum in the Greater Mekong Subregion threatens both the efficacy of artemisinin-based combination therapy (ACT), the first-line treatment for malaria, and prospects for malaria elimination. Monitoring of ACT efficacy is essential for ensuring timely updates to elimination policies and treatment recommendations. In 2014-2015, we assessed the therapeutic efficacies of artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DP) for the treatment of uncomplicated P. falciparum at three study sites in Rakhine, Shan, and Kachin states in Myanmar. Patients presenting with uncomplicated P. falciparum malaria were enrolled, treated, and followed up for 28 days for AL or 42 days for DP. Both AL and DP demonstrated good therapeutic efficacy at all three study sites. The 28-day cure rate for AL was > 96% across all study sites, and the 42-day cure rate for DP was 100%. Parasitemia on day 3 was detected in 0%, 3.3%, and 3.6% of participants treated with AL at the Rakhine, Shan, and Kachin sites, respectively. No participants treated with DP were parasitemic on day 3. No evidence of P. falciparum k13 mutations was found at the Rakhine study site. A high prevalence of k13 mutations associated with artemisinin resistance was observed at the Kachin and Shan state study sites. These results confirm that ACT efficacy has been resilient in therapeutic efficacy study (TES) sentinel sites in Myanmar, despite the presence at some sites of k13 mutations associated with resistance. Studies are ongoing to assess whether this resilience persists. Copyright © 2020 by The American Society of Tropical Medicine and Hygiene
Authors & Co-Authors
Han, Kay Thwe
Myanmar, Yangon
Ministry of Health and Sports
Lin, Khin
Myanmar, Yangon
Ministry of Health and Sports
Thi, Aung
Myanmar, Yangon
Ministry of Health and Sports
Aye, Kay Hla
Myanmar, Yangon
Ministry of Health and Sports
Bustos, Maria Dorina Geluz
Switzerland, Geneva
Organisation Mondiale de la Santé
Ringwald, Pascal
Switzerland, Geneva
Organisation Mondiale de la Santé
Simmons, Ryan A.
United States, Durham
Duke University
Markwalter, Christine F.
United States, Durham
Duke University
Plowe, Christopher Vv
United States, Durham
Duke University
Nyunt, Myaing Myaing
Unknown Affiliation
Statistics
Citations: 5
Authors: 10
Affiliations: 3
Identifiers
Doi:
10.4269/ajtmh.19-0692
ISSN:
00029637
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study